Audit of Management of Gallbladder Cancer in a Nigerian Tertiary Health Facility

Aetiological Spectrum of Pancreaticobiliary Diseases in Adult Nigerians on Magnetic Resonance Cholangiopancreatography

BACKGROUND

Imaging is vital for assessing pancreaticobiliary diseases.

AIM

The aim of the study was to investigate the spectrum and pattern of pancreaticobiliary diseases in adult Nigerians using magnetic resonance cholangiopancreatography (MRCP).

METHODS

This was a retrospective, descriptive cross-sectional study. The electronic radiological records of 110 adult Nigerians who had undergone MRCP were reviewed. The MRCP images were evaluated for bile duct dilatation, intraluminal filling defects, strictures, calculi, and other abnormalities.

RESULTS

There were 45 males (40.9%) and 65 females (59.1%) aged 18-83 years, with a mean age of 51.93 ± 15.22 years. Jaundice (59.1%) and right hypochondrial pain (31.8%) were the most common presenting complaints. Gallstones (32.7%), common bile duct strictures (15.5%), choledocholithiasis (11.8%), pancreatic head carcinoma (10.9%), and gallbladder carcinoma (2.7%) were the most frequent abnormalities. There was biliary obstruction in 56.4% of participants, mostly at the distal and proximal common bile duct. Other findings include hepatomegaly (23.6%), hepatic cysts (6.4%), hepatic steatosis (0.9%), duodenal wall thickening (1.8%), and ascites (5.5%). MRCP was normal in 25 (22.7%) participants.

CONCLUSION

Gallstones were the predominant pathology of the various pancreaticobiliary diseases, while Pancreatic head and gallbladder carcinoma were the most common malignant diseases.

Gallbladder cancer in Africa: A higher than expected rate in a "low-risk" population

BACKGROUND

Gallbladder cancer is the most common biliary tract malignancy. Reports from Africa suggest a low incidence of gallbladder cancer. Gallbladder cancer is most often diagnosed incidentally on pathology after cholecystectomy. The aim of this study was to determine the rate of incidental gallbladder cancer from cholecystectomy specimens in South Africa.

METHODS

An audit of cholecystectomies for suspected gallstone disease in South Africa was done by reviewing specimens processed by the South Africa National Health Laboratory Service from 2003 and 2015. To assess risk factors for the presence of malignancy, a case control comparison was done. Logistic regression was used to determine the association between risk factors and malignancy. Between-group comparisons of sex were carried out using Fisher exact test. Ages were compared using the independent samples t test.

RESULTS

Pathological analysis was conducted on 33,467 cholecystectomy specimens. The rate of incidental gallbladder cancer rate was 0.39% with no difference between gender (P = .19). The mean age of the incidental gallbladder cancer patients (61.8 years; SD 13.4 y) was significantly higher than that of patients without gallbladder cancer (47.2 years; SD 15.0) (P < .0001). The majority of patients presented with T2 and T3 tumors. On multivariate analysis, only age, the presence of acute inflammation, and dysplasia were associated with the presence of incidental gallbladder cancer.

CONCLUSION

This large African study demonstrates a high rate of incidental gallbladder cancer in a patient population that has previously been deemed at low risk for gallbladder malignancies.